维生素D 缺乏在慢性阻塞性肺疾病患者中患病率及对患者生活质量的影响

目的:了解慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD) 患者群中维生素D 缺乏的患病率,并探讨维生素D 缺乏对COPD 患者生活质量的影响。方法:收集2011 年12 月至2012 年3 月在长沙市第三医院呼吸内科住院的COPD 急性加重期患者36 例(COPD 急性加重组) 和同期同院门诊随诊的COPD 稳定期患者38 例(COPD 稳定组),同时选择在同院体检中心健康体检者30 例(对照组)。采用ELISA 法测定3 组受试者血清25-(OH)D水平。计算和比较3 组中维生素D 缺乏的患病率。分别对COPD 急性加重组和稳定组患者进行COPD 评估测试(COPDassessment test,CAT) 评分,比较维生素D 缺乏对两组COPD 患者CAT 评分的影响。结果:1) 3 组研究对象的血清25-(OH)D 水平比较,COPD 急性加重组和COPD 稳定组分别低于对照组,COPD 急性加重组低于COPD 稳定组,差异均有统计学意义(P<0.05)。2) 维生素D 缺乏的患病率在COPD 急性加重组为52.78%,COPD 稳定组为39.47%,对照组为16.67%;COPD 组维生素D 缺乏的总患病率为45.95%。3 组的维生素D 缺乏患病率总体分布差异有统计学意义(P<0.05)。3) 3 组维生素D 缺乏的患病率比较,COPD 急性加重组高于对照组(P<0.01),COPD 稳定组高于对照组(P<0.05),COPD 急性加重组与COPD 稳定组比较差异无统计学意义(P>0.05)。4)COPD 急性加重组和COPD 稳定组患者的CAT评分差异有统计学意义(P<0.01)。5)COPD 急性加重组25-(OH)D 水平与CAT 评分呈负相关(r=-0.603,P<0.01),COPD稳定组25-(OH)D 水平与CAT 评分呈负相关(r=-0.549,P<0.01)。结论:维生素D 缺乏在COPD 患者中有较高的患病率;维生素D 缺乏可能对COPD 患者的生活质量有负面影响。

Prevalence of vitamin D deficiency and impact on quality of life in patients with chronic obstructive pulmonary disease

Objective: To survey the prevalence of vitamin D deficiency in patients with chronic obstructive pulmonary disease (COPD) and to determine the impact of vitamin D deficiency on the quality of life in COPD patients. Methods: Thirty-six patients with acute exacerbations of COPD (AECOPD group), 38 outpatients with stable COPD (stable COPD group), and 30 healthy subjects (control group) in the Third Hospital of Changsha were enrolled in our study from Dec. 2011 to Mar. 2012. The serum levels of 25-(OH)D were measured in all subjects by ELISA. The prevalence of vitamin D deficiency was calculated and compared among the 3 groups. Scores of COPD assessment test (CAT) were measured and compared in the AECOPD group and the stable COPD group and the relation between 25-(OH)D and CAT scores was analyzed. Results: 1) The levels of 25-(OH)D in the AECOPD group and the stable COPD group were significantly lower than those in the control group. The level of 25-(OH)D in the AECOPD group was significantly lower than that in the stable COPD group (P<0.05). 2) The prevalence of vitamin D deficiency was 52.78% in the AECOPD group and that was 39.47% in the stable COPD group. The total prevalence of vitamin D deficiency was 45.95% in COPD patients. The prevalence of vitamin D deficiency was 16.67% in the control group. There was significant difference in the prevalence of vitamin D deficiency among the 3 groups (P<0.05). 3) The prevalence of vitamin D deficiency in the AECOPD group was significantly higher than that in the control group (P<0.01) and the prevalence of vitamin D deficiency in the stable COPD group was significantly higher than that in the control group (P<0.05). There was no significant difference between the AECOPD group and the stable COPD group (P>0.05). 4) significant difference was found between the AECOPD group and the stable COPD group in CAT scores (P<0.01). 5) Both in the AECOPD group and the stable COPD group, the 25-(OH)D levels were negatively correlated with CAT scores (r=-0.603, P<0.01; r=-0.549, P<0.01, respectively). Conclusion: Vitamin D deficiency is highly prevalent in COPD patients. Vitamin D deficiency may have negative impact on the life quality in COPD patients.